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BCC forehead focal perineural invasion pt3 nerve

Lukodi
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Hello this is my first post. I have had a leison on my forehead for about 4-5 years and past GP's have given antibiotic cream to help it but it never healed. In December I was sent by a new GP for 2ww to dermatology and had a biopsy which came back benign. I had a dermatologist appointment 4 weeks later and thats where I was told it was BCC and I would need a wide excision. I had that 3 weeks later. On Wednesday I got my results and was told it had all been removed but I had focal perineural invasion is noted pt3 nerve diameter 0.1mm bcc. My consultant said the treatment would be radiotherapy but because of my age (44) they will not do this and I will have to just keep an eye on it. That has made me worry that it has progressed and I have to just leave it. Now I'm very poorly at the moment and my excision wound is infected, I have a massive coldsore, fatigue is horrible and have bad headaches. I know this might be my body just needing rest but also scared its to do with my aggressive BCC.

  • Hi Lukodi

    As youve had the BCC lesion for 4 or5 years it is slow growing and not aggressive. The wait and see is quite normal but the refusal to offer you radiotherapy because of your age at a spritely 44 does not seem right. Ive had radiotherapy in my 50's and 60's for BCC and SCC skin lesions where the surgical removal has not been complete. Get a second opinion on this. The infection of your wound is likely causing your run down health symptoms. The NHS hate issuing antibiotics but if the infection is severe you can demand a prescription, it is your health at stake and the cosmetic outcome of the healed wound. Best wishes for your recocovery.

    Ed

  • Hello Lukodi and thank you for posting

    It sounds like the last few months have been really stressful for you, so it’s completely understandable that you’re feeling worried.

    The good news is that your BCC has been fully removed. When deciding whether to offer radiotherapy, doctors carefully balance the benefits against the possible side effects. They consider factors such as whether the cancer was completely excised and whether the margins were clear. In younger people, radiotherapy is often avoided because it can increase the risk of developing another skin cancer in the treated area in the future. This may be the reason it hasn’t been recommended for you.

    If you’re still feeling unsure, it may be helpful to ask your team to explain their decision in more detail. Some questions that may be helpful: why radiotherapy isn’t being offered, what the follow‑up plan is, how you’ll be monitored, and what they believe your risk of recurrence is. As Farmer Ed mentioned, if you are concerned, you can also request a second opinion, which some people find reassuring.

    The symptoms you’re experiencing are much more likely to be related to an infection than to the BCC, as the cancer has already been removed. Feeling run-down or unwell can often come with an infection.

    I hope this helps. Please get back in touch if you need any more information or support. If you’d prefer to speak to someone, you can call the nurses on the helpline Monday to Friday, 9am to 5pm, on freephone 0808 800 4040.

    Jemma

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